IBD MIMICS PRESENTED AT IBD LIVE: WHEN IT IS NOT INFLAMMATORY BOWEL DISEASE

Abstract BACKGROUND A group of Inflammatory Bowel Disease (IBD) specialists have been utilizing a weekly live video conference “IBD Live” to discuss multidisciplinary management challenging cases. Since 2009 the has featured robust interactive case discussions among 150-200 gastroenterologists and colorectal surgeons from multiple academic institutions. Although majority cases presented are IBD, there number where IBD was not ultimate diagnosis. Hence, we sought characterize these mimics” provide structure for differential METHODS All 106 hours conferences recorded archived between May 2018 June 2021 were reviewed. total 183 215 discussed had an diagnosis including 124 Crohn’s disease (CD), 54 ulcerative colitis (UC) 5 unclassified. RESULTS Many remaining 32 (14.9%) (Table 1) referred specialist with prior IBD. There 10 colonic inflammation initially diagnosed as UC. Etiologies included drug-induced secondary checkpoint inhibitors cancers, ocrelizumab sclerosis, nintedanib pulmonary fibrosis. ischemic colitis, idiopathic myointimal hyperplasia mesenteric veins, segmental associated diverticulosis, diversion colitis. 8 systemic diseases, Common Variable Immunodeficiency, sarcoidosis vasculitis, Henoch–Schönlein purpura CTLA4 haploinsufficiency autoimmune infiltrates. ileal disorders, ultimately lymphoma, tuberculosis, Meckel’s diverticulum, appendiceal carcinoid all previously thought be CD. small bowel mucosal disorders collagenous sprue enteropathy, 2 polyposis Cronkhite-Canada juvenile syndromes. also penetrating complications CD, abdominal actinomyces infection. Finally, 3 no consensus made, broad diagnoses cryptogenic multifocal ulcerous stenosis enteritis. CONCLUSIONS mimics found in 15% at global webinar 3-year period. Clinicians should high level suspicion actively pursue alternative etiologies when patients do respond anticipated therapy and/or characteristics completely consistent These non-IBD will lead significant change medical, surgical pharmacological treatment approaches, which impact cost, unplanned care quality. Our Live positively impacted our patients, magnified importance considering "mimics."